Chemotherapy given before and after resection of liver metastases significantly reduces risk of recurrent metastases in patients with colorectal cancer, according to results of a phase III trial presented at the annual meeting of the American Society of Clinical Oncology.

The European study was the first to evaluate this treatment strategy and used the FOLFOX4 combination regimen (5-fluorouracil, leucovorin, oxaliplatin).

“This approach may become the standard of care for patients with liver metastases from colorectal cancer that can be surgically removed,” said Bernard Nordlinger, MD, Professor of surgery and Chairman of surgery and oncology at Ambroise Pare Hospital, Paris. “The findings also support a multidisciplinary approach to care, with all members of the patient’s health care team collaborating to determine the optimal combination of chemotherapy and surgery.”

Historically, patients with liver metastases have had surgical resection wherever possible, but recurrence is common and survival is relatively short, with roughly one third surviving five years after resection of hepatic metastases.

Between September 2000 and July 2004, researchers associated with four major European cancer organizations randomized 182 patients with colorectal cancer and liver metastases that were considered appropriate for surgery to receive six cycles of chemotherapy preoperatively and six additional cycles after surgery. A matched group of 182 patients received surgery only.

Some patients in both groups failed to undergo surgery for one or more medical reasons. A total of 151 patients in the chemotherapy arm and 152 patients in the control arm had their metastases resected. At a median follow-up of 3.9 years, 42.4 percent of chemotherapy patients still had no evidence of recurrence, whereas only 33.2 percent of the control group had no evidence of recurrence.